Great Epidemics Research Articles

PCR testiranje na SARS-CoV-2 - praksa, preporuke i nedoumice

In the Covid-19 pandemic, diagnostic laboratories have met multiple new demands, which have gone beyond the existing personnel, technical and material capacities. According to the current recommendations, the base of laboratory diagnostics for Covid-19 is a Real-Time Reverse Transcription Polymerase Chain Reaction (rtRT-PCR) test, which detects the presence of SARS-CoV-2 genome in the biological material collected from the patient. The procedure of testing can conditionally be divided into several stages: 1) setting the indications for testing; 2) collecting the clinical samples and filling in the documentation; 3) transport of the material to the diagnostic laboratory; 4) reception and classification of the material; 5) the analysis of samples after the reception - the preparation for rtRT-PCR; 6) rtRT-PCR; 7) communicating results. It is clear that medical microbiological services have not been standardized for the fight against the pandemic or great epidemics. The most efficient way to overcome such a situation is to define teams, which would take part in the diagnostics, when the epidemiological situation demanded it. It is necessary to strive to have the unified equipment on the whole territory of the Republic of Serbia, because in that way the maintenance and procurement of spare parts and consumables are made easier, and the purchasing price could possibly be lowered. Reagents for the extraction and specific reagents for rtRT-PCR (primers and probes) should be standardized and made in Serbia in order to decrease the dependence on imports and make significant money savings. The database of laboratory results should be improved and organized according to the FAIR (findability, accessibility, interoperability, and reusability) principles in order to use the possibility of making conclusions maximally.

FROM FLORENCE NIGHTINGALE TO THE COVID-19 PANDEMIC: THE LEGACY WE WANT

ABSTRACT Objective: to reflect on the future of the nursing profession based on the impact of the COVID-19 pandemic on the goals of the Nursing Now campaign and the celebration of Florence Nightingale's bicentennial. Method: reflexive analysis presented in two central topics: the first deals with Florence Nightingale-precursor of entrepreneurship in nursing; the second deals with the COVID-19 pandemic, the consequent turnaround of the Nursing Now campaign and the strengthening of nursing as a valuable profession. Results: in the first topic, we point out the fundamental aspects of the trajectory of Florence Nightingale as the creator of modern nursing worldwide through advances, innovations, scientificity and correlation of its principles with the current reality. In the second topic, we historically reflect on the activities of Nursing in the great wars and epidemics up to the present, correlating the practices and the way nursing is constituted as a profession. We point out the goals of the Nursing Now campaign and its significance post-pandemic, as well as the expansion of nursing visibility and the constitution of a new professional identity. Conclusion: finally, we reflect on the importance of nurses pursuing their efforts to grant visibility to their expertise in all fields of work and knowledge, strengthening the identity and the professional image we want to anchor in society and maintain for the future.

Yellow fever outbreak in Brazil: the puzzle of rapid viral spread and challenges for immunisation.

We discuss the complex eco-social factors involved in the puzzle of the unexpected rapid viral spread in the ongoing Brazilian yellow fever (YF) outbreak, which has increased the reurbanisation risk of a disease without urban cases in Brazil since 1942. Indeed, this rapid spatial viral dissemination to the Southeast and South regions, now circulating in the Atlantic Forest fragments close to peri-urban areas of the main Brazilian megalopolises (São Paulo and Rio de Janeiro) has led to an exponential increase in the number of yellow fever cases. In less than 18 months, 1,833 confirmed cases and 578 deaths were recorded most of them reported in the Southeast region (99,9%). Large epizooties in monkeys and other non-human primates (NHPs) were communicated in the country with 732 YF virus (YFV) laboratory confirmed events only in the 2017/2018 monitoring period. We also discuss the peculiarities and similarities of the current outbreak when compared with previous great epidemics, examining several hypotheses to explain the recent unexpected acceleration of epizootic waves in the sylvatic cycle of the YFV together with the role of human, NHPs and mosquito mobility with respect to viral spread. We conclude that the most feasible hypothesis to explain this rapidity would be related to human behavior combined with ecological changes that promoted a significant increase in mosquito and NHP densities and their contacts with humans. We emphasize the urgent need for an adequate response to this outbreak such as extending immunisation coverage to the whole Brazilian population and developing novel strategies for immunisation of NHPs confined in selected reserve areas and zoos. Finally, we stress the urgent need to improve the quality of response in order to prevent future outbreaks and a catastrophic reurbanisation of the disease in Brazil and other South American countries. Continuous monitoring of YFV receptivity and vulnerability conditions with effective control of the urban vector Aedes aegypti and significant investments in YF vaccine production capacity and research and development for reduction of adverse effects are of the highest priority.

“Under the Stimulus of Great Epidemics”: Reformers, Epidemics, and the Rise of State Level Public Health in Pennsylvania, 1872–1905

ABSTRACT Though Pennsylvania was a prosperous industrial state and home to a great many medical institutions, it was among the last to constitute state-level public health organs. Pennsylvania's first public health organization, the Board of Health, was founded in 1885 and was ineffectual. Its second public health organ, the Department of Health, founded in 1905, rapidly gained a reputation as the strongest state health department in the nation. Though the aims and powers of the two organizations were vastly different, they were linked by the central role that epidemics played in motivating the legislature to pass bills that founded the organizations. Chief among the outbreaks that compelled the legislature to act in the best interests of the commonwealth's health were epidemics of typhoid in Plymouth in 1885 and Butler in 1903. This article explores the link between epidemic outbreaks during a twenty-year period and the state's public health organizations.

Building Infectious Disease Research Programs to Promote Security and Enhance Collaborations with Countries of the Former Soviet Union

Addressing the threat of infectious diseases, whether natural, the results of a laboratory accident, or a deliberate act of bioterrorism, requires no corner of the world be ignored. The mobility of infectious agents and their rapid adaptability, whether to climate change or socioeconomic drivers or both, demand the science employed to understand these processes be advanced and tailored to a country or a region, but with a global vision. In many parts of the world, largely because of economic struggles, scientific capacity has not kept pace with the need to accomplish this goal and has left these regions and hence the world vulnerable to infectious disease outbreaks. To build scientific capability in a developing region requires cooperation and participation of experienced international scientists who understand the issues and are committed to educate the next generations of young investigators in the region. These efforts need to be coupled with the understanding and resolve of local governments and international agencies to promote an aggressive science agenda. International collaborative scientific investigation of infectious diseases not only adds significantly to scientific knowledge, but it promotes health security, international trust, and long-term economic benefit to the region involved. This premise is based on the observation that the most powerful human inspiration is that which brings peoples together to work on and solve important global challenges. The republics of the former Soviet Union provide a valuable case study for the need to rebuild scientific capacity as they are located at the crossroads where many of the world’s great epidemics began. The scientific infrastructure and disease surveillance capabilities of the region suffered significant decline after the breakup of the Soviet Union. The U.S. Cooperative Threat Reduction (CTR) Program, a part of the U.S. Department of Defense, together with partner countries, have worked diligently to improve the capabilities in this region to guard against the potential future risk from especially dangerous pathogens. The dissolution of the Soviet Union left behind many scientists still working to study pathogens using antiquated protocols in unsafe laboratories. To address this situation, the CTR program began improving laboratory infrastructure, establishing biosafety and biosecurity programs, and training scientists in modern techniques, with emphasis on biosurveillance and safe containment of especially dangerous pathogens. In the Republic of Georgia, this effort culminated in the construction of a modern containment laboratory, the Richard G. Lugar Center for Public Health Research in Tbilisi to house both isolated especially dangerous pathogens as well as the research to be conducted on these agents. The need now is to utilize and sustain the investment made by CTR by establishing strong public and animal health science programs in these facilities tailored to the needs of the region and the goals for which this investment was made. A similar effort is ongoing in other former Soviet Republics. Here, we provide the analysis and recommendations of an international panel of expert scientists appointed by the Cooperative Biological Engagement Program of the Defense Threat Reduction Agency to provide advice to the stakeholders on the scientific path for the future. The emphasis is on an implementation strategy for decision makers and scientists to consider providing a sustainable biological science program in support of the One Health initiative. Opportunities, potential barriers, and lessons learned while meeting the needs of the Republic of Georgia and the Caucasus region are discussed. It is hoped that this effort will serve as a model for similar scientific needs in not only the former Soviet Union republics but also other regions challenged by infectious diseases where the CTR program operates.

West Nile Encephalitis and Its Characteristics in Childhood.

Dear Editor, West Nile virus (WNV) is a member of the family flaviviridae. Culex mosquitoes and birds are playing crucial role in the spread of WNV. It can also spread through blood transfusions, organ transplants and from mother to baby in the course of breastfeeding (1). WNV was first isolated in a village of Uganda and many epidemics related to this disease have been reported ever since. However, as of this date, great epidemics have been reported in Africa, Europe, Russia and Israel (2). Although various data were given in epidemiologic studies in Turkey, we could reach only one case report from child age group in our country (3). With this letter, for the first time, we aimed to draw attention to the issue by defining WNV infection and its characteristics in children. We present five cases diagnosed West Nile Infection who were admitted with meningo-encephalitis. Cerebrospinal fluid findings and clinical properties of the five cases are summarized in Tables 1 and ​and22. Table 1. Cerebrospinal Fluid (CSF) Findings of Cases Table 2. Demographic Findings of Cases Epidemiological studies show that the disease is increased during summer. The nature of the disease is closely related with mosquitos, all of our cases were seen in August-September. WNV is a mosquito borne disease with epidemics in regions where mosquitoes are common between May and October. In our cases, the average age of five children was 9.2. The diagnosis of these five children was established detecting IgM positivity in blood sample taken within 14-18 days after onset of symptoms. The disease has been detected in serological analysis performed in our country. WNV occurs generally with encephalitis symptoms in children under one and adults over 60 years. In a different study in the same region in 2010, encephalitis was detected in five cases in an epidemic. Average age was 64.6. These five cases presented with fever, headache, nausea, vomiting, muscle pains, and consciousness (4). Neuroinvasive WNV disease is generally in the form of meningitis, encephalitis or acute flaccid paralysis. Extrapyramidal symptoms, ataxia, optic neuritis, myelitis and the signs of cranial nerve involvement are the neurological symptoms that occur less frequently. Encephalitis-meningo-encephalitis by itself is more frequent than meningitis (5). Rash frequency is 50%. Rash is typically localized in chest, back and arms, and it has maculo-papular character. Rash is a crucial prognostic indicator for severe disease and death (6). While WNV is symptomatic progressive in elders, it is generally asymptomatic progressive in young. WNV was detected in 1478 children in USA between 1999 and 2007 (7). There was neck stiffness in three cases, Kernig and Brudzinski positivity in two cases. Although rash in WNV encephalitis is reported in various sources, we observed it in only one case in our study. In this case, rash appeared on legs and it was of maculo-papular characteristic. In CSF (Cerebrospinal fluid) analysis of WNV encephalitis, protein may be normal or slightly high. CSF protein, CSF glucose and CSF cell count of the cases was between 20-200 mg/dL, 49-66 mg/dL and 0-500 mm3 respectively. Hence, children with WNV encephalitis resented with typical signs of aseptic meningitis. According to our experience, WNV clinical signs of encephalitis started suddenly, and headache and fever were present in all children. WNV must be taken into consideration in suspicious cases in beginning of autumn and mid-summer in provinces located on the migration route of birds. In summer, before diagnosing aseptic meningitis in a child with headache, encephalitis and fever, WNV testing should be done.

A brief prehistory of Huntington's disease.

Physicians and family members alike have long been curious about the historical origins of Huntington’s disease. Despite the fact that families with “hereditary chorea” were described in medical literature for the first time in the 1840s, most authors agree that the genetic abnormality and most likely the panoply of symptoms we know today as Huntington’s disease were present centuries earlier in Europe and the Americas, and probably in other parts of the world as well. Twentieth century medical writers have tried to link modern Huntington’s disease with the great European dance epidemics of the 14th, 15th, and 16th centuries known as St. Vitus’s dance or danse de St. Guy. They have cited as possible precedents the descriptions of chorea Sancti Viti by the Renaissance physician Paracelsus of Basel, the witch trials of the 17th century in northern Europe and New England, and the accounts of post-rheumatic chorea in children in the late 17th and 18th centuries, written by the English physician Thomas Sydenham and others. They have

Actualidades farmacológicas en el tratamiento de la insuficiencia cardiaca crónica

La insuficiencia cardiaca es, actualmente, una de las grandes epidemias del nuevo siglo. Durante las últimas dos décadas se ha incrementado de manera dramática y exponencial, ubicándose como la primera causa de morbimortalidad y hospitalización a nivel mundial hasta en un 159% y ocupando 10% de morbilidad en la población mexicana. Es por esto que en la actualidad se ha modificado drásticamente el rumbo del tratamiento farmacológico, dejando de lado la paliación de las complicaciones propias de la evolución del padecimiento, enfocándose hacia la identificación y ruptura de los eslabones más precisos que conforman la cadena de acontecimientos adaptativos fisiológicos desencadenados por la misma, los cuales, durante los últimos años, se ha demostrado que son causantes directos de la progresión patológica de la enfermedad y la exacerbación de un sistema de retroalimentación positivo que se magnifica a sí mismo. En la presente revisión se contemplan los diferentes mecanismos compensatorios de la insuficiencia cardiaca, como los objetivos directos del tratamiento farmacológico actual, partiendo de los archivos de la Revista Española de Cardiología y la Revista Mexicana de Medicina Interna. Con este nuevo enfoque se pretende aminorar la mortalidad y los índices de hospitalización de manera importante, y al mismo tiempo mejorar la calidad de vida de las personas que la padecen.

Study of life style habits on risk of type 2 diabetes

Background:Diabetes mellitus has become one of the great epidemics of our time,Aim:Characterized by derangement of carbohydrate, protein and fat metabolism. Diabetic patients may have some other habits like drinking, smoking, lack of physical activity. In the present study, we have tried to study the effect of all these habits on lipid profile and antioxidative enzymes, i.e., catalase and superoxide dismutase.Materials and Methods:Different kits and standard biochemical methods were used to estimate all these parameters.Results:Diabetics as well as diabetic individuals who were engaged in drinking, smoking and regular physical exercise showed a significant rise in glucose levels compared to normal subjects. Similarly, cholesterol, triglyceride and high-density lipoprotein cholesterol levels and activity of catalase were found to be increased in all diabetic subjects, but that of superoxide dismutase decreased as compared to normal subjects. In all cases, exercise has a beneficial effect. Furthermore, females were more prone to destructive effects of diabetes than males.Conclusion:We can conclude that smoking and drinking by diabetic subjects further deteriorates the effects of diabetes, while regular physical exercise has beneficial effects.

Adomnán, plague and the Easter controversy

AbstractAdomnán's description (Vita Columbae II.46) of how the intercession of St. Columba preserved the Picts and the Irish in Britain alone among the peoples of western Europe against two great epidemics of bubonic plague is a coded defence of their use of the traditional Irish 84-year Easter table against the Dionysian Easter table as used throughout the rest of western Europe. His implication is that God sent the plagues to punish those who used the Dionysian table. Hence Adomnán still adhered to the 84-year table by the time that he composed the Vita Columbae c. 697. It probably took a third epidemic 700–c. 702 to persuade Adomnán that his interpretation of the earlier epidemics was incorrect, so that Bede (HE V.15) is correct to date his conversion to the Dionysian table to a third visit to Northumbria c. 702.

Bioterrorismo: dados de uma história recente de riscos e incertezas

Today, bioterrorism is a real threat in the whole world. Considering the actions of bioterrorism by using biological agents capable of promoting great epidemics and overload in the health systems of any city, state or country, the bioterrorism is not only a health professional concern, but government and military also. This article discusses a bibliographical review done in the LILACS, MEDLINE, SciELO and REPIDISCA databases, during the period of 1997 the 2007, the characteristics of related national publications to the bioterrorism, the type of biological agents studied, and the existing knowledge in the country to face a bioterrorism event, in order to feed with information the professionals who will act in first reply to the bioterrorism events and that are essential to reduce the number of victims.

Histórico das hepatites virais

The history of viral hepatitis goes back thousands of years and is a fascinating one. When humans were first infected by such agents, a natural repetitive cycle began, with the capacity to infect billions of humans, thus decimating the population and causing sequelae in thousands of lives. This article reviews the available scientific information on the history of viral hepatitis. All the information was obtained through extensive bibliographic review, including original and review articles and consultations on the internet. There are reports on outbreaks of jaundice epidemics in China 5,000 years ago and in Babylon more than 2,500 years ago. The catastrophic history of great jaundice epidemics and pandemics is well known and generally associated with major wars. In the American Civil War, 40,000 cases occurred among Union troops. In 1885, an outbreak of catarrhal jaundice affected 191 workers at the Bremen shipyard (Germany) after vaccination against smallpox. In 1942, 28,585 soldiers became infected with hepatitis after inoculation with the yellow fever vaccine. The number of cases of hepatitis during the Second World War was estimated to be 16 million. Only in the twentieth century were the main agents causing viral hepatitis identified. The hepatitis B virus was the first to be discovered. In this paper, through reviewing the history of major epidemics caused by hepatitis viruses and the history of discovery of these agents, singular peculiarities were revealed. Examples of this include the accidental or chance discovery of the hepatitis B and D viruses.

On Putting the Active Back into Activism

INTRODUCTION This paper addresses a paradox: how to engage in affirmative politics, which entails the production of social horizons of hope, while at the same time doing critical theory, which means resisting the present. This is one of the issues Deleuze and Guattari discuss at length, notably in What is Philosophy?: (1) the relationship between creativity and critique. It is however a problem that has confronted all activists and critical theorists, namely how to balance the creative potential of critical thought with the necessary dose of negative criticism and oppositional consciousness. Central to this debate is the question of how to resist the present, more specifically the nastiness, violence and vulgarity of the times, while being worthy of our times, so as to engage with the present in a productively oppositional and affirmative manner. I shall return to this in the final section of my essay. There is a conceptual and a contextual side to this problem and I want to start by discussing each one, before addressing my central concern. I. THE CONTEXT The public debate today shows a decline of interest in politics, whereas discourses about ethics, religious norms and values triumph. Some master-narratives circulate, which reiterate familiar themes: one is the inevitability of capitalist market economies as the historically dominant form of human progress. (2) Another is a contemporary brand of biological essentialism, under the cover of 'the selfish gene' (3) and new evolutionary psychology. Another resonant refrain is that God is not dead. Nietzsche's claim rings hollow across the spectrum of contemporary global politics, dominated by the clash of civilizations and widespread Islam phobia. The bio-political concerns that fuel our necro-politics and the perennial warfare of our times also introduce a political economy of negative passions in our social context. Thus the affective economy expresses our actual condition: we now live in a militarised social space, under the pressure of increased enforcement of security and escalating states of emergency. The binary oppositions of the Cold War era have been replaced by the all-pervasive paranoia: the constant threat of the imminent disaster. From the environmental catastrophe to the terrorist attack, accidents are imminent and certain to materialise: it is only a question of time. In this context, mass political activism has been replaced by rituals of public collective mourning. Melancholia has become a dominant mood and a mode of relation. There is, of course, much to be mournful about, given the pathos of our global politics: our social horizon is war-ridden and death-bound. We live in a culture where religious-minded people kill in the name of 'the Right to Life' and wage war for 'Humanitarian' reasons. Depression and burn-out are major features of our societies. Psych-pharmaceutical management of the population results in widespread use of legal and illegal drugs. The narcotic sub-text of our societies is under-studied and mostly denied. Bodily vulnerability is increased by the great epidemics: some new ones, like HIV, Ebola, SARS or the bird flu; others more traditional, like TB and malaria. Health has become more than a public policy issue: it is a human rights and a national defence concern. While new age remedies and life-long coaching of all sorts proliferate, our political sensibility has taken a forensic shift: 'bare life', as Agamben argues, (4) marks the liminal grounds of probable destitution--infinite degrees of dying. At the same time European culture is obsessed with youth and longevity, as testified by the popularity of anti-ageing treatments and plastic surgery. Hal Foster (5) describes our schizoid cultural politics as 'traumatic realism'--an obsession with wounds, pain and suffering. Proliferating medical panopticons produce a global patho-graphy: (6) we go on television talk-shows to scream our pain. …

Foreign medical help in Serbian liberation wars from 1912 until 1918

This work concerns involvement of the foreign medical missions during the Serbian Liberation Wars from 1912 until 1918, the work of their members immediately behind the front lines and in the back, healing of the wounded and the diseased, especially at the time of the great epidemics of typhoid fever, and also the efforts of numerous Serbian friends who collected the funds and material for equipping and sending of those missions. An American mission which came first to Serbia, soon after the beginning of the war operations and which was led by Dr. Edward Ryan, was specially mentioned. For many smaller of bigger missions, it is known that they acted in some of the Serbian war zones. A special attention was paid to the work of The Scottish Women's Hospital, its formation and means of funding, work in war conditions, attitudes towards wounded Serbs and posture during the Serbian retreat before the German, Austro-Hungarian and Bulgarian occupying armies. This text is largely the author's own view of his two books on medical assistance which the Serbs received from their friends from abroad (Medical Missions at Serbian Battlefields 1912-1918 and The Scottish Women with the Serbs 1914-1918). The first of these booklets contains a list with over 1350 names (of which, approximately 700 are the medical doctors), and the other 1230, were based on the author's personal inspection of the available literature and materials, significantly increased the official data of the Serbian Red Cross about the number of medical staff who reached Serbian battlefields: doubles them for the Balkan wars, while in the Great war they were at least five times greater.

Predicting the Development of Atherosclerosis

Tis easy to see, hard to foresee. — —Benjamin Franklin Atherosclerotic vascular disease is one of the great epidemics of the 21st Century.1 Decades before its clinical manifestation, endothelial dysfunction (ED) marks the beginning of an insidious disease process, which silently progresses to a point where it can only be slowed but not reversed. ED is induced by a variety of mediators, some of which are known and related to established cardiovascular risk factors such as smoking, dyslipidemia, hypertension, diabetes mellitus, and aging, whereas others are presently unknown. As ED develops, the balance between antiatherogenic and proatherogenic factors in slowly shifted in favor of the latter. In this multifactorial process, reduced bioavailability of nitric oxide (NO) plays a pivotal role. NO, a free radical gas with an in vivo half-life of a few seconds, is synthesized primarily from endothelial NO synthase (eNOS), which is activated in response to flow-induced shear stress, cytokines, and hormones.2 In vitro, NO inhibits the expression of cell adhesion molecules such as VCAM-1, ICAM and E-selectin, as well as the secretion of proinflammatory cytokines such as interleukin 6 and interleukin 8, thus preventing monocyte attraction and adhesion.3 In line with these findings, early studies using eNOS knockout mice demonstrated an increase in atherosclerotic lesions in these animals.4,5 In contrast, however, more recent studies revealed that eNOS knockout mice may under certain circumstances also be relatively protected from the development of atherosclerosis and that transgenic overexpression of eNOS in fact may accelerate atherogenesis.6,7 Although the exact mechanism remains unclear, it is highly likely that in the inflammatory microenvironment of the dysfunctional endothelium and developing atherosclerotic lesion, increased oxidative stress leads to an immediate chemical reaction of NO with superoxide, resulting in the generation of peroxynitrite, thereby both reducing the bioavailability of NO …

DUTY TO CARE: ACKNOWLEDGING COMPLEXITY AND UNCERTAINTY

DUTY TO CARE: ACKNOWLEDGING COMPLEXITY AND UNCERTAINTY

SUB-SPECIALTY TRAINING OF ENDOCRINOLOGY IN THE ISLAMIC REPUBLIC OF IRAN: ESTIMATING THE NEED FOR ENDOCRI-NOLOGIST TRAINING

Endocrinologists contribute to the care of sizable populations with diabetes, thyroid disorders, obesity, metabolic syndrome, osteoporosis, dyslipidemia, pituitary disease, adrenal disease, male and female reproductive disorders and menopausal women. In addition, the trend of prevalences of endocrine and metabolic disorders show that these diseases are highly prevalent, with none becoming less common; on the contrary, diabetes and obesity are the great epidemics of the third millennium. Based on the number of hospital beds, required office-based services, trend of endocrinology diseases, current prevalence of this disease, an estimated 860 endocrinologist are needed while at present there are only 146 adult endocrinologists are practicing. Efforts are urgently needed to find solutions for this gap in the endocrinology workforce if quality services is to be offered.

Influenza virus

Every year, especially during the cold season, many people catch an acute respiratory disease, namely flu. It is easy to catch this disease; therefore, it spreads very rapidly and often becomes an epidemic or a global pandemic. Airway inflammation and other body ailments, which form in a very short period, torment the patient several weeks. After that, the symptoms of the disease usually disappear as quickly as they emerged. The great epidemics of flu have rather unique characteristics; therefore, it is possible to identify descriptions of such epidemics in historic sources. Already in the 4th century BC, Hippocrates himself wrote about one of them. It is known now that flu epidemics emerge rather frequently, but there are no regular intervals between those events. The epidemics can differ in their consequences, but usually they cause an increased mortality of elderly people. The great flu epidemics of the last century took millions of human lives. In 1918–19, during “The Spanish” pandemic of flu, there were around 40–50 millions of deaths all over the world; “Pandemic of Asia” in 1957 took up to one million lives, etc. Influenza virus can cause various disorders of the respiratory system: from mild inflammations of upper airways to acute pneumonia that finally results in the patient’s death. Scientist Richard E. Shope, who investigated swine flu in 1920, had a suspicion that the cause of this disease might be a virus. Already in 1933, scientists from the National Institute for Medical Research in London – Wilson Smith, Sir Christopher Andrewes, and Sir Patrick Laidlaw – for the first time isolated the virus, which caused human flu. Then scientific community started the exhaustive research of influenza virus, and the great interest in this virus and its unique features is still active even today.

A modern epidemic

Allergy: The History of a Modern Malady by Mark Jackson Reaktion Books, London, UK 288 pp, $40/£25 ISBN 1861892713 ![][1] The great epidemics of the past resulted from infection: influenza, yellow fever and the plague. Today, these have largely been replaced by new epidemics of chronic disease—such as cardiovascular disease and type II diabetes—the etiologies of which are as much social and economic as they are biological. In Allergy: The History of a Modern Malady , Mark Jackson traces one such epidemic from its roots in nineteenth‐century immunology to its current status as one of the most pervasive maladies afflicting mankind. In doing so, he has written a remarkably concise, accessible, and yet intellectual account of the essential role that history has in understanding the socioeconomic, cultural, and environmental origins of allergy and other modern diseases. Throughout the book, Jackson provides an historical overview of the term ‘allergy’, describing how its meaning has changed over time and how, at any one moment, its perception has varied between scientists, clinicians and the lay public. In 1905, Clemens von Pirquet, an Austrian … [1]: /embed/graphic-1.gif

Nephron Number, Uric Acid, and Renal Microvascular Disease in the Pathogenesis of Essential Hypertension

One of the world’s greatest epidemics is the epidemic of essential hypertension, which during the last 100 years has increased from a prevalence of 5% to 10% in the European and American population to >30% today. Hypertension was nonexistent in other places of the world but has risen to similar frequencies with the introduction of Western diet and culture. As a major cause of stroke, heart disease, and kidney disease, hypertension is a major underlying cause of morbidity and mortality, and therefore understanding its underlying etiology is critically important. The groundbreaking studies of Dahl and Guyton led to the recognition of the key role for the kidney in the pathogenesis, but controversy remains on the precise mechanism. The observations that several hereditary causes of hypertension result from genetic mutations that lead to increased sodium reabsorption in the nephron (particularly in the collecting duct) has led to a search for genetic causes.1 However, although genetic polymorphisms are clearly important, most studies suggest genetic mechanisms may only have a modest (20%) influence on the hypertensive phenotype.2 A congenital mechanism, or fetal programming, has also been proposed (the “Barker-Brenner hypothesis”).3,4 Low birth weights (LBWs) predispose to the later development of hypertension as well as other cardiovascular diseases, including obesity and diabetes. LBW infants often have impaired kidney development, resulting in a reduced nephron endowment. Following birth, the children have an increased risk for developing endothelial dysfunction and obesity, and by adulthood …